Governor's Office Emergency Services
Hazardous Materials Spill Report

    DATE: 05/19/2024
    TIME: 1116
    RECEIVED BY:
    CONTROL#:
    Cal OES - 24-2865
    NRC -
1.a. PERSON NOTIFYING Cal OES:
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
Modesto Fire Department
1.b. PERSON REPORTING SPILL (If different from above):
1. NAME:2. AGENCY:3. PHONE#:4. Ext:5. PAG/CELL:
2. SUBSTANCE TYPE:
2. a. SUBSTANCE:b.QTY:>=<Amount Measurec. TYPE:d. OTHER:e. PIPELINEf. VESSEL
>= 300 Tons
1. Class A Foam=1 Gal(s)CHEMICALNoNo
2. Water=400 Gal(s)OTHERWaterNoNo
3. = NoNo
g. DESCRIPTION: The reporting party states while flushing their water tank on their fire engine there was a release of approximately 1 gallon of Class A Foam mixed with 400 gallons of water. The release made its way into a storm drain that leads into the Stanislaus River. The release is stopped and contained. The reporting party conducted the clean up.
h. STOPPAGE/CONTAINMENT:i. WATER INVOLVED: j. WATERWAY:k. DRINKING WATER IMPACTED
Stopped, ContainedYesStorm Drain, Stanislaus RiverYes
l. MARITIME VESSEL
No		m. KNOWN IMPACT
None
3. a. INCIDENT LOCATION: 17700 Main St
b. CITY:c. COUNTY: d. ZIP:
Knights Ferry
Stanislaus County95361SAN JOAQUIN VALLEY UNIFIED APCD
4. INCIDENT DESCRIPTION:
a. DATE:b. TIME (Military):c. SITE:d. REPORTED CAUSE
05/19/20240930 Other
Description for Other : Fire Station		Human Error
e. INJURIESf. FATALITY g. EVACUATIONh. CLEANUP BY:
NoNoNoReporting Party
6. NOTIFICATION INFORMATION:
a. ON SCENE:b. OTHER ON SCENE: c. OTHER NOTIFIED:
d. ADMIN. AGENCY: Stanislaus County Environmental Resourcese. SEC. AGENCY:
f. ADDITIONAL COUNTY: g. ADMIN. AGENCY:
h. NOTIFICATION LIST:
Cal GEM:
RWQCB Unit:

5B
Cal OES Region:
AA/CUPA, DTSC, RWQCB, US EPA, USFWS, DWP-DO, LANDS, PARKS & REC, Co/WP, Co/Hlth, Co/E-Hlth
Photo Attachment:
11. Cal OES Reg.
********* Control No: 24-2865 *********

Created by: Warning Center on: 05/19/2024 11:16:05 AM Last Modified by: Warning Center on: 05/19/2024 11:29:00 AM